Provider Demographics
NPI:1629164652
Name:WESTLEIN, KATHRYN MARIE (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:WESTLEIN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3565 ELLICOTT MILLS DR. C2
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043
Mailing Address - Country:US
Mailing Address - Phone:410-916-0280
Mailing Address - Fax:443-592-9004
Practice Address - Street 1:3565 C2 ELLICOTT MILLS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4544
Practice Address - Country:US
Practice Address - Phone:410-916-0280
Practice Address - Fax:443-592-9006
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD106021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD334424000Medicaid
MD334424000Medicaid